ABSTRACT
One of the therapeutic options in patients with symptomatic coronary artery disease is coronary artery bypass graft surgery. Compared with the coronary arteries grafts have a larger diameter, are less calcified, and are more stationary, which makes them easier to image by computed tomography (CT). Initial attempts to assess the coronary arteries by four-slice CT demonstrated poor interpretability and accuracy to detect obstructive disease. Ischemic symptoms in patients after bypass surgery can be caused by obstructive bypass graft disease or by progression of disease in the native coronary arteries. One advantage of CT is that it allows visualization of the heart beyond the coronary/graft lumen. Knowledge of the obstructive pathology may be helpful prior to intervention. The accuracy of CT angiography to detect obstructive graft disease is almost 100%. Comprehensive post-bypass surgery evaluation should also include the assessment of the native coronary arteries, which may prove challenging as a result of advanced, diffuse coronary artery disease.
